A few weeks ago, the United States House of Representatives passed House Bill 6833, a law that limits out-of-pocket insulin expenses to a maximum of $35 per month for diabetic patients. The bill had bipartisan support – 12 Republicans crossed party lines to vote with their fellow Democrats. Representative Matt Gaetz of Florida was one of 193 Republicans who opposed the bill. After the vote, he tweeted “arbitrary price checks do not replace individual weight checks”. Essentially, Gaetz blamed high insulin prices on Americans’ “expanding the size” instead of the pharmaceutical industry’s rising prices.
The outlandish claim is not only stupid, it is incorrect. And this time, a nonsensical statement from a politician hits close to home.
I am one of the 37 million Americans with diabetes. I have had type 2 diabetes – a condition where the body cannot control blood sugar without insulin or oral medication – for the past 5 years. I am the third generation in my family to live with this chronic condition, starting with my mother’s father, a family doctor, who was diagnosed with it in the mid-1960s and treated with insulin for the rest of his life. life.
After I stopped breastfeeding my youngest son at age 41, I applied for additional life insurance coverage. It was during this evaluation that blood tests revealed that my blood sugar was slightly higher than it should have been. Over the next 6 weeks, I drastically reduced my sugar and fat intake. Until then, I had a balanced diet, enjoying healthy foods while enjoying the occasional treat every once in a while. I was reluctant to restrict my intake after overcoming an eating disorder in college, something I no longer wanted to deal with. However, these restrictive dietary changes did not solve my problem. A repeated test, known as hemoglobin a1c, continued to climb after ingesting little or no sugar a few months later. I needed medicine to treat my condition.
There are two types of diabetes. Type 1 diabetes is an autoimmune disease, usually triggered by a viral infection, that destroys cells in the pancreas, the organ that regulates the release of insulin, a hormone that controls blood sugar levels. Type 1 diabetics are unable to produce insulin and require insulin injections for the rest of their lives through no fault of their own.
In type 2 diabetes, the pancreas does not work well enough on its own to control blood sugar. Some people with type 2 diabetes can only take medication by mouth, which improves the body’s insulin efficiency to regulate blood sugar. Other people with type 2 need oral medications and insulin as their condition progresses.
The risk of developing type 1 diabetes is relatively unpredictable; the risk of type 2 diabetes is usually the result of a genetic predisposition associated with obesity, poor diet and a sedentary lifestyle. But not everyone with type 2 diabetes is obese. I’m just over five feet tall and weigh 110 pounds. I am active, taking at least 10,000 steps a day, but also playing tennis, running or chasing my children on their various adventures. Genetically, my pancreas just drew a little stick. And I’m not alone.
Diabetes is the most expensive chronic disease in the United States, costing $237 billion a year. Nearly $1 out of $4 in healthcare costs in the United States is spent on caring for people with diabetes. Over the past decade, insulin costs have tripled. While a single vial of insulin costs only $2 to $6 to produce, patients pay between $50 and $1,000 for a single vial. Studies reveal that one in four patients ration insulin because they cannot afford the increased out-of-pocket expenses.
Implementing national legislation to regulate drug prices could stabilize or potentially reduce insulin costs for consumers in the United States. Analysis by the Kaiser Family Foundation found that a $35 per month cap on out-of-pocket expenses could benefit more than 1 in 4 Americans in the individual and small group markets and 1 in 5 in large plans. sponsored by the employer.
Why is there so much opposition to this kind of sensible legislation in the first place? It seems that too many lawmakers, like Gaetz, are simply out of touch with the average American. In April 2021, the House Ethics Committee announced that it had opened an investigation following reports that Gaetz was under investigation by the Justice Department for his relationship with a young girl. age 17 and the payments he might have made to other women. for sex. In fact, the only drug legislation supported by Gaetz involved relaxing marijuana regulations, an effort unlikely to improve Americans’ health.
Too many Americans depend on insulin for survival to leave such important decisions to legislators who cannot understand the basic science. As the Insulin Act passes through the Senate, let’s hope that the majority of senators will understand the fact that insulin treatment is not just for obese people. Diabetes is a disease, not everyone has a choice.
Dr Niran Al-Agba is a pediatrician at Silverdale and writes a regular column for the Kitsap Sun. Contact her at [email protected]